Obesity in pregnancy tied to myocardial dysfunction over postpartum period: Study

Italy: Obesity during pregnancy in women aged ≥ 35 yrs, and low chronic inflammation is tied to a significantly increased risk of persistent subclinical myocardial dysfunction over the postpartum period, reveals a recent study. The study appears in The International Journal of Cardiovascular Imaging. 

No previous research has provided a complete functional evaluation of all the heart chambers in pregnant women with obesity. Moreover, there is no clarity on the impact of cardiovascular changes associated with obesity in pregnancy on maternal outcomes. 

Andrea Sonaglioni, Ospedale San Giuseppe MultiMedica IRCCS, Milan, Italy, and colleagues examined 46 consecutive pregnant women with obesity, defined by body mass index (BMI) ≥ 30 Kg/m2, and 83 age- (35.5 ± 4.1 vs. 34.1 ± 5.1 yrs), gestational week-matched (36.3 ± 1.7 vs. 36.5 ± 1.5 wks), and ethnicity- (caucasian 65.2 vs. 66.3%) pregnant women without obesity (BMI < 30 Kg/m2) in the first trimester (12–14 weeks), third trimester (36–38 weeks) and 6–10 weeks postpartum. 

All women underwent blood tests, obstetric visits, and transthoracic echocardiography performed with two-dimensional speckle tracking echocardiography analysis of biventricular and biatrial myocardial deformation indices at the three-time points. Myocardial dysfunction, defined as an absolute value of left ventricular global longitudinal strain (LV-GLS) less negative than − 20%, postpartum was the outcome. 

Based on the study, the researchers found the following:

Despite
normal biventricular systolic function, all myocardial strain indices were
significantly lower in pregnant women with obesity than in controls. At 8.2 ± 2.2 weeks postpartum, LV-GLS
remained less negative than − 20% in 86.9% of women with obesity
in pregnancy. Maternal age
(OR 1.68), third trimester BMI (OR 7.17), and third-trimester
neutrophil-to-lymphocyte ratio (NLR) (OR 1.75) were independently associated
with outcome. Maternal age ≥ 35 years, BMI ≥ 30 Kg/m2, and
NLR ≥ 5.5 were the
optimal cut-off values for predicting persistent subclinical myocardial
dysfunction in postpartum.

To conclude, pregnant women with obesity, age ≥ 35 yrs and low chronic inflammation are at a significantly increased risk of persistent subclinical myocardial dysfunction over postpartum.

Reference:

Sonaglioni, A., Nicolosi, G.L., Bianchi, S. et al. Obesity in pregnancy is a predictor of persistent subclinical myocardial dysfunction over postpartum period. Int J Cardiovasc Imaging (2022). https://doi.org/10.1007/s10554-022-02579-y

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